Since time immemorial, shoes have protected feet against hazardous surfaces and
the cold. Over the years, they have also become fashion accessories and indicators
of group membership and social status.
Since the 1970s, even athletic footwear has succumbed to fashion and aesthetics, as
designers have tried to respond to growing consumer demand for stylish products.
The past 20 years alone have brought about an explosion in technological
developments. Hoping or claiming to reduce the risk of injury, manufacturers have
designed and incorporated increasingly complex cushioning, support and stability
features into sports shoes. These technologies, combined with eye-catching designs,
achieved one essential goal: to sell shoes.
Despite the millions of dollars that multinationals invest every year in the promotion of
new, so-called “protective” technologies, there have been very few published studies
and no solid evidence to back up these technological advances. The cushioning of
running shoes, for example, has no impact whatsoever on the skeletal system,
despite clever attempts by manufacturers to incorporate such features into
increasingly elaborate products (Ethylene Vinyl Acetate, Polyurethane, Gel, Air,
Adiprene, Wave System, Shox, etc.). Not only has cushioning never been shown to
prevent injury, but it has also been known to disrupt the natural dynamics and
proprioceptive mechanisms of the foot. Thus, in their attempts to reduce injury, shoe
manufacturers have made sports shoes increasingly heavier, bulkier and pricier.
Some researchers today believe that these changes may even be responsible for
certain pathologies such as hallux valgus (bunions) and Achilles tendinitis, which are
much less frequent in barefoot populations. In short, despite the modern
technological advances and complex manufacturing processes that go into sports
shoes, athletes keep getting injured. Given these observations, it is essential that we
ask whether the claims made by those who promote such lucrative technologies
(shoe manufacturers, sports magazines, retailers, etc.) really are accurate.
1. CHOOSING SPORTS SHOES
There is a considerable lack of consensus and scientific evidence concerning which
criteria a professional should use to recommend a given type of sports shoe.
Nevertheless, choosing athletic footwear should be based on two basic principles:
1) The right fit
The size, width and shape of the shoe should fit the shape of the foot, without
causing pressure points or deforming the toes. The shoe should feel comfortable
as soon as you put it on.
The shoe should interfere as little as possible with the natural protective
biomechanics of the foot. (For example, shoe cushioning increases instability, heel
height increases the risk of ankle sprain and alters running biomechanics, wide
soles disrupt pronotation dynamics).
Other sport-specific criteria may also serve as a guide for choosing appropriate
The shoe should provide adequate grip. The design and type of material used in
the outsole of a shoe or the addition of spikes under the shoe can maximize grip
depending on the surface. For example, certain types of rubber outsoles may
provide better grip on certain gym surfaces. The same applies to the spike length
and type of outdoor soccer shoes and the type of field; the type of spikes on
sprinting shoes and the type of track; the type of crampons on hiking boots and
the type of surface conditions.
Stability and sports involving lateral movements
The shoe should adequately support the foot in order to provide lateral stability to
the ankle and the foot in sports that involve a lot of quick lateral movements (e.g.
soccer, basketball, tennis, physical fitness training).
Many strategies are used to provide stability, including straps on the instep or the
upper part of the shoe, lateral reinforcements of the quarter (high cuts), optimal
lacing systems, wider soles or heel stiffeners. The most important criteria,
however, is the height of the sole, which should be as low as possible to decrease
the lever effect.
Lightness and endurance sports
The weight of a shoe has an important effect on oxygen consumption. Several
studies on runners have shown that a 1% increase in shoe weight can cause a 3%
increase in oxygen consumption. In other words, for all sports where performance
is influenced by an “endurance” factor, i.e. sports such as running, soccer, boxing
or basketball, shoes must be lightweight in order to reduce cardiovascular
requirements and consequently improve physiological performance.
Flexibility and certain specific sports
A flexible shoe that does not interfere with the foot’s natural dynamics is
recommended for long-distance running, while a shoe with a very rigid sole may
improve performance in sprinting and jumping, according to certain authors.
Shoes for dancing, rock-climbing or gymnastics should be flexible enough to allow
certain specific dynamics necessary for performance.
Anti-pronation features and running shoes
Despite the fact that there is no clear scientific evidence to support their
effectiveness, anti-pronation features (the denser and darker-coloured section of
the midsole) are incorporated into running shoes in an attempt to reduce
Thus, runners and walkers whose arches fall abnormally when their feet hit the
ground could benefit from purchasing shoes with anti-pronation features.
Depending on the requirements of a sport or activity, certain secondary criteria
may also influence the choice of shoe. Breathability of the sole and shoe upper
may prove useful in hot weather as it helps reduce perspiration; a waterproof
upper may be useful in hiking shoes and in rainy or damp conditions; light
reflectors on running shoes will make a runner visible at night; the rigidity and
snugness of a downhill ski boot support the ankle and foot, allowing immediate
and optimal control of skis; padding in cross-country ski boots keeps feet warm in
cold weather, etc.
2. SPECIAL SHOES AND NEW TECNOLOGIES
Based on the assumption that the foot has what it takes to protect itself against
injury and that the dynamics of bare feet are the benchmark of proper walking and
running biomechanics, an impressive number of new shoes have appeared on the
market in response to this paradox (e.g. Biom, Five Fingers Vibram, Nike Free,
MBT Shoes, Newton Shoes).
Even though the design of these shoes is based on interesting theories, it is
nevertheless important to critically assess these new trends and marketing
influences. It is also important to proceed gradually when changing from one type
of shoe to another, particularly if the new shoe involves a significant change in
biomechanics (such as a substantial difference in the thickness of the sole).
3. SPECIFIC POPULATIONS
Diabetics suffering from peripheral neuropathies (loss of sensitivity in the
extremities) should pay particular attention to foot comfort. The fit and comfort of
their sports shoes is of the utmost importance since diabetics are advised to
minimize the risk of skin lesions caused by irritation. Cushioning and foot orthoses
could prove essential features in this regard.
1. Shop for shoes at the end of the day, after you’ve been active (your feet will be
at their widest, since they swell slightly with activity).
2. Shop in a store that offers a wide range of shoes and choose a shoe based on
the type of sport and its requirements.
3. Try on both shoes inside the store; wear sports socks and lace the shoes up
4. Do a few dynamic moves such as running and jumping.
5. Make sure the shoes feel comfortable as soon as you put them on (good fit, no
pressure points, heel doesn’t slip, etc.).
6. Leave one centimetre of space between the toes and the end of the shoe (you
should be able to wiggle your toes freely inside the shoe, except in certain types
of shoes such as dancing or hiking shoes).
7. The price of a shoe is not an indication of quality and definitely not one of
protection against injury.
8. Sports shoes have a limited lifespan. However, contrary to popular belief, it is
not the shoes’ cushioning that should be monitored but rather the amount of
wear and any deformations that could increase the risk of injury.
9. Your weight should not determine the size or cushioning of your shoes, only the
quality of the shoes’ uppers, which should be a little sturdier.
10. Break in your shoes gradually to give your body time to adjust to the new
The protective qualities of footwear have always been prized. Since the beginning of
time, leather sufficed to shield us against sharp rocks, cold and snow. With the
advent of new manufacturing technologies and the discovery of new materials,
engineers, influenced by marketing departments, have gotten carried away with new
designs. In the last 20 years alone, sports shoes have evolved as much as they had
in the previous 4000. However, despite all the technological advances, we now
realize that choosing good sports shoes should depend on two simple criteria:
comfort and simplicity.
Written by: Blaise Dubois, B.Sc. P.T. RCAMT, Sports physiotherapy, Conseil de
médecine du sport du Québec (CMSQ)
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